Breast Augmentation

What is a breast augmentation?

A breast augmentation is a cosmetic surgical procedure performed to enlarge the breasts. There is a choice between two types of implants: silicone or saline. The implants are placed into a woman’s body either behind the breast tissue or the chest muscle. It is a cosmetic procedure and will not be covered by your insurance.

Why do women get breast implants?

A breast augmentation is one of the most common plastic surgeries sought by women of all ages for various reasons. The American Society of Aesthetic Plastic Surgery identified Breast Implants as the #1 cosmetic surgery for women age 24-42. ASAPS Statistics There are many reasons women choose to get breast implants here are just a few:

First, some women simply wish to have larger breasts. While there is no one “correct” size for a woman’s breasts, many women feel as though their breasts are too small for their bodies.

Next, women seek augmentation to correct asymmetrical breasts, that is, breasts that differ in size. There are only a very small percentage of women that have perfectly symmetrical breasts, but the difference between the two breasts may vary slightly to a much larger difference. The breasts may differ in both size and shape.

Next, many women want a breast augmentation because they feel as though their breasts have deflated. This lack of fullness may have been caused by a small to significant weight loss, aging, or after having children.

Finally, women may want a breast augmentation due to a congenital abnormality called tubular breast deformity. This is a condition that many women are unaware even exists, but between one and five percent of all breast augmentations completed are for this condition. To learn more about it please visit our Tubular Breast Deformity page here.

Once you have decided that you would like to have a breast augmentation, you should first investigate whether or not you are a candidate for surgery. Although one should come in for a consultation to determine whether or not surgery is an option, here are a few of the reasons patients are typically turned away from our office:

Dr. McClellan does not perform any elective, cosmetic surgery on smokers. This is for a variety of reasons including poor wound healing and an increased risk of infection.

One common misconception about breast implants is that as soon as you are 18 you may get an augmentation; however, this is only partially true. As of November 2006, the FDA approved silicone implants only for women over the age of 22. This means that patients between the ages of 18 to 21 are only allowed to have saline implants. The difference between the two types of implants will be described if further detail in the next section. Unfortunately, these younger women can shop around to other plastic surgery offices and find a surgeon that would have no problem giving them silicone implants; Dr. McClellan is not one of these surgeons. Patient safety is his number one concern and maintaining his code of ethics is something that he pledged and continues to follow in his practice.

Body dysmorphic disorder is a condition in which a person is obsessed with reaching perfection in their bodies, typically by getting at least one surgery, but generally multiple surgeries. Someone with this condition is not likely a candidate for a breast augmentation performed by Dr. McClellan because it is important for one to set realistic surgical goals.

What are the potential risks involved with a Breast Augmentation?

As with any surgery, there are risks involved with getting a breast augmentation. Here is a list of some of the more common complications:

Infection – Anytime that your body is opened up and a foreign object is placed into it, there is a chance for infection. Dr. McClellan, as well as the Operating Room (OR) staff, works tirelessly to ensure that every measure is taken to minimize the potential for infection.

Implant Rupture – It is possible for both saline and silicone implants to rupture. For saline implants, it is generally easy to tell if the implant has ruptured. The breast(s) will look deflated and it will happen over a short period of time. A slow leaking saline implant is rare. If a saline implant ruptures, the saline is absorbed by the body. It is generally harmless, unless the inside of the implant was contaminated. It is more difficult to tell whether a silicone implant has ruptured. Our silicone implants use a technology known as Memory Gel so that if the outside of the implant was cut, the silicone will stay in place and not leak out into the body. For those who have had a breast augmentation it is important to get an MRI done of the body every two to three years to make sure that the implants are in good condition.

Capsular Contracture – This is a tightening of the tissue capsule that the surgeon has created around the implant. If untreated there is a high risk for implant rupture. Capsular contracture is evaluated by a system called the Baker Grades. A description of each of the Baker Grades is given below. If you reach stage III or IV you will need a revision surgery. This will include a capsulectomy, or removal of the scar tissue capsule that has formed around the breast, and a re-augmentation, if you would like to continue to have breast implants.

Baker Grade I – The breast is soft and has a natural appearance.

Baker Grade II – The breast is more firm, but still looks normal.

Baker Grade III – The breast is more firm and looks abnormal.

Baker Grade IV – The breast is hard and is obviously distorted; it is painful to the touch.

What is the difference between silicone and saline breast implants?

Initially, saline implants were all that was available and were the gold standard for breast augmentation. Since silicone implants have been introduced and approved by the FDA, silicone implants are more widely used. Here is a small comparison between the two types of implants:

Silicone

Saline

If your implant ruptures, the Memory Gel will keep your implant together so that you do not have an instant deflated-looking breast.

If your implant ruptures, you will have a visibly deflated breast.

Looks more natural in the body.

You may be able to see the rippling of the implant in your body. This is especially true for thin, petite women that have thin skin.

What is the difference between sub-muscular and sub-glandular placement of breast implants?

Implants may be positioned in the sub-muscular, behind the breast tissue and pectoralis muscle, or in the sub-glandular, behind the breast tissue, position. Again, once you have your initial, free consultation with Dr. McClellan he will be able to tell you which placement would be better for you. However, here is some more information about the differences and similarities between them:

Sub-Muscular

Sub-Glandular

Decreased likelihood of capsular contracture

Increased likelihood for capsular contracture

Easier for imaging after surgery

More difficult for imaging after surgery

Preferable if there is little or thin, weakened breast tissue

Not recommended if there is little or thin, weakened breast tissue

What is the difference between incision sites?

There are four main sites in which the incision may be made to place the implant. Here is a list of the sites and why or why not Dr. McClellan uses them:

Periareolar – This incision is made around the nipple-areola complex. Because the incision is around the nipple, using this technique creates a greater risk for change in nipple sensation. Additionally, it causes an increase in breast feeding difficulties if one were to have a child after the surgery.

Transaxillary – This incision is made in the armpit. A probe is placed under the arm that allows the surgeon to see where the implant is being placed; however, it is more difficult for the surgeon to perform the augmentation from this position due to the limited visibility. Furthermore, the implant has a large distance to travel from this location and is therefore at a higher risk to be damaged while it is being placed. It is also difficult to ensure that the implant has been placed in the proper position to give the optimal results.

Inframammary – This incision is made along the inframammary fold, just beneath the breast. This is the incision that Dr. McClellan uses and is most widely used by plastic surgeons. This location allows the surgeon the most visibility and the best access to place the implant. This type of incision can be used for both sub-muscular as well as sub-glandular placement.

Umbilical – This incision is made through the umbilicus, or belly button. Dr. McClellan does not offer this type of incision for breast augmentation. In fact, Mentor, our implant provider, has not studied how much the implant may be damaged while it is moving through the body to be placed.

What can I expect for the surgery and recovery?

Breast augmentation surgery is performed at Monongalia General Hospital typically as an outpatient procedure (you do not stay overnight in the hospital) under general anesthesia. Attention to detail, technique, and handling of the implant are crucial to the most optimal outcome which is why Dr. McClellan, as well as his OR staff, takes this surgery very seriously.Dr. McClellan will see you for your post-operative appointment the day after surgery. On that day, he will teach you how to do your massages to help keep the implants mobile and help them set in the best-possible position. Massaging your implants is something that Dr. McClellan will stress to you, but without massaging the implant the chance for capsular contracture increases significantly.

Depending on the nature of your work, most patients are back to work after four or five days. Pain varies from patient to patient and Dr. McClellan will continue to remind you that you just had a major surgery – you must take it easy. After the first seven to ten days you may resume your normal day-to-day activities. Two to three weeks after surgery you may begin walking at a slow pace and doing minimal exercising. Four to six weeks post surgery Dr. McClellan will release you to do as you wish.

What should I expect at my initial consultation?

For a breast augmentation consultation you should allow at least 45 minutes in our office. Plan to come about 15 minutes early to your appointment to fill out the necessary forms. During your consultation Dr. McClellan will show you a PowerPoint presentation to give you more information about breast augmentation surgery and answer any of your questions. It is often helpful to have a list of questions that you may have or something that you need clarification on.

After you meet with Dr. McClellan, you will then be escorted to Becky Miller’s office. She is our patient coordinator and will provide you with the price quote for the surgery as well as give you information about what financial options are available. As the patient coordinator, Becky makes every effort to ensure that you are ready and feel comfortable before surgery.

Patients are encouraged to bring a sports bra with them in order to try on implants and determine the best fit and size for them. Implant size does not have to be finalized at this consultation and patients are encouraged to contact Becky in order to schedule a separate appointment if they are still trying to determine the size that is right for them.

Out of Town Patients

Dr. McClellan performs breast augmentation on many patients that drive a distance from throughout West Virginia, Maryland, and Pennsylvania. Breast implant patients frequently come from Beckley, Clarksburg, Charleston, Huntington, and Parkersburg, West Virginia; Deep Creek, Oakland, and Western Maryland, as well as Uniontown and Waynesburg Pennsylvania. Our office is very adept at easing the process of distant consultation, travel and flow-up for our patients.

We have hotel information available and have negotiated special rates for patients who travel.

A few frequently asked questions about Breast Augmentation you should consider before undergoing surgery include:

Is the surgeon Board Certified by the American Board of Plastic Surgery?

December 5, 2012
Did you know that McClellan Plastic Surgery and MD & SPA offer gift certificates? Why not stop in and pick one up for that special someone for the holidays or for another special time during the year? Call for more details or stop by! Read more